Improving Clinical Handover on an Electronic Communication Platform: A Quality Improvement Project

Area of Science:

• Medical Quality Improvement
• Patient Safety
• Healthcare Communication

Background:

• National guidance emphasizes essential components for safe patient handovers.
• Increased staff turnover and redeployment, exacerbated by the COVID-19 pandemic, challenge effective handover delivery.
• Standardized handover tools are crucial for consistent clinical communication.

Purpose of the Study:

• To improve adherence to a standardized handover proforma.
• To enhance the quality and consistency of clinical handovers.
• To address challenges in handover communication within a healthcare setting.

Main Methods:

• A quality improvement project utilized Plan-Do-Study-Act (PDSA) cycles.
• Data collected from an electronic handover system based on the Situation, Background, Assessment, and Recommendations (SBAR) structure.
• Completion rates of handover components were measured before and after interventions across junior doctor rotations.

Main Results:

• Significant improvements observed in 'Situation' components (admission/discharge dates) and 'Assessment' elements (escalation status, issues list).
• Documentation of social history increased by 12.1%, while 'Recommendations' completion remained at 100%.
• Despite overall improvements, challenges persisted due to junior doctor rotations and COVID-19 surge rotas.

Conclusions:

• The quality improvement project successfully enhanced adherence to most handover proforma components.
• Staff rotation and pandemic-related disruptions impact the sustainability of handover improvements.
• Transitioning to a fully integrated electronic patient record (ePR) system with a handover tool may offer a more durable solution.